POS0080 PROGNOSTIC FACTORS ASSOCIATED WITH NON-REMISSION OR LOW DISEASE ACTIVITY STATUS AFTER 1 YEAR OF PSORIATIC ARTHRITIS PATIENTS TREATMENT IN REAL PRACTICE
Authors: E. Loginova, T. Korotaeva, E. Gubar, Y. Korsakova, S. Glukhova
Journal: Annals of the Rheumatic Diseases (2022)

Background Remission/Low Disease Activity (LDA) are acceptable goal of psoriatic arthritis (PsA) treatment. According to registry data 32.8%- 60.3% of PsA patients (pts) are considered to be in remission under biological (b) DMARDs treatment [1, 2]. Prognostic factors for non-remission/LDA hasn’t been fully studied yet and data is limited. Objectives to determine the prognostic factors associated with non-remission/LDA status within 1 year of treatment in PsA pts in real practice. Methods 292 pts (M/F=122/170) with active PsA fulfilling the CASPAR criteria were included. Mean age 46.1±12.5 years (yrs.), PsA duration 10.4±7.1 months (mos.), psoriasis (Ps) duration 19.32±12.08 mos., body mass index (BMI) 27.7±5.6 kg/m 2 , Median (Me) DAPSA 23.8 [14.7; 37.4]. 182 pts was given therapy with synthetic (s) DMARDs predominantly Methotrexate (MTX), 110 pts – bDMARDs as monotherapy or with combination with MTX or other sDMARDs. At baseline (BL) and at 1 year of therapy PsA activity by tender/swelling joint count (TJC)/68, (SJC)/66, Pain (VAS), Patient global assessment disease activity (PtGA, VAS), CRP mg/l, dactylitis, enthesitis by LEI and plantar fascia, BSA (%), HAQ, DAPSA were evaluated. DAPSA&gt;28 indicate high disease activity (HDA), 15-28 - moderate activity (MoDA), 5-14 - LDA, ≤4 - remission. By 1 year of therapy the proportion of pts who had not reached remission or LDA were calculated. The one-factor model of logistic regression was used to identify a group of features that are associated with remission or LDA nonachievement. M±SD, Me [Q25; Q75], Min-Max, %, t-test, Peаrson-χ 2 , Manna-Whitney tests, ORs with 95% CI were performed. All p&lt;0.05, were considered to indicate statistical significance. Results At 1 year of therapy 116 pts of 292 (39.7%) have HDA/MoDA by DAPSA. Remission/LDA was reached in 176 pts (60.3%), 110 of them (62.5%) were treated with bDMARDs. Comparative analysis in both groups and one-factor model of logistic regression showed the following features at BL were associated with non-remission/LDA status: TJC&gt;3 (p&lt;0.001), SJC&gt;5 (p&lt;0.001), CRP&gt; 10 mg/l (p&lt;0.001), HAQ&gt;0.5 (p&lt;0.001), presence of entesitis (p&lt;0.001), dactylitis (p&lt;0.001), BMI&gt;30 (p&lt;0.002) and had to be treated with sDMARDs. PsA pts with combination of these clinical features at first visit have more chance to non-remission/LDA status in comparison to PsA pts without them, OR with CI 95% (Figure 1). Figure 1. The prognostic factors associated with non-remission/LDA status in PsA pts Conclusion In real practice remission/LDA can be seen in 60% of PsA pts treated mostly with bDMARDs. But about 40% of PsA pts still have HAD/MoDA despite going through therapy. It is a combination of clinical features at BL – TJC&gt;3, SJC&gt;5, CRP&gt;10 mg/l, HAQ&gt;0.5, presence of entesitis, dactylitis, BMI&gt;30 kg/m 2 and sDMARDs therapy - that constitutes a prognostic factor with negative impact on achievement remission/LDA after 1 year of treatment. References [1]Mease P, et al. Arthritis Rheumatol. 2020; 72 (suppl 10). acrabstracts.org . 2. Murray K, et al. Arthritis Research &amp; Therapy 2021; 23:25. doi.org/10.1186/s13075-020-02380-z . Acknowledgements The Russian PsA Registry study group. Disclosure of Interests Elena Loginova Speakers bureau: Janssen, Tatiana Korotaeva Speakers bureau: Pfizer, MSD, Novartis, AbbVie, Janssen, Lilly, Celgene, JSC BIOCAD and Novartis-Sandoz, ELENA GUBAR: None declared, Yulia Korsakova Speakers bureau: Novartis, Svetlana Glukhova: None declared